A day in the life of an locum anatomical pathology technologist

Anatomical pathology technologist Mike Elton (FAAPT) talks us through a typical day in the mortuary and wonders why it is that people seem to be scared of talking about death.

“I started my career in 1997 at The Royal Hampshire County Hospital, Winchester. For years I worked for the NHS and local authorities, before leaving the comforts of a nine to five job in 2011 to work as a full-time locum. I can honestly say I’ve never looked back.

Back then, it took four years to qualify as an anatomical pathology technologist (APT). I had to train in a mortuary full time, working alongside the senior APT for support and guidance. After two years I got my certificate in anatomical pathology technology from the Royal Institute of Public Health. A further two years training enabled me to take the diploma in anatomical pathology technology. I learnt about anatomy and physiology, health and safety, COSHH, risk assessments and, importantly, how to deal with bereaved families.

The profession has naturally evolved, and now has its own association: the Association of Anatomical Pathology Technologists (www.aaptuk.org), which offers a vast amount of information, training and networking with colleagues throughout the UK. New qualifications have been introduced; there is now a level 3 and level 4 diploma in anatomical pathology technology, both of which are covered by day release and assessment training. In 2004, mortuaries became regulated by the Human Tissues Authority (HTA). They introduced codes of practice and standards that must be adhered to. A bit like Ofsted, but for mortuaries.

All in a days work

Working in the mortuary, no two days are the same. Starting at 8am, I check to see if there are any new admissions, recording patient’s name, address, date of birth, place of death and any property left on or with the body.

In the meantime, other colleagues will prepare the deceased for any post-mortems that have been arranged by the coroner’s office. For my allocated cases, I assist the pathologist with an external examination of the body, noting down scars or any other markings on the body. I then begin the careful evisceration of the body; removing the organs for the pathologist to examine. Occasionally the pathologist will ask for other samples to be taken from the body - blood, urine, vitreous and bile for example - for toxicology tests. The pathologist may also take tissue samples, which are sent to the histopathology laboratory for further analysis. Following the post-mortem examination I reconstruct the body to a high standard. This process can happen several times a day depending how many cases are on the day’s list.

A ring on the doorbell may signal the arrival of a family wishing to come in and pay their respects to a loved one. The body is removed from the fridge, placed on the viewing trolley and moved into the viewing room - a private area for the families to have time to sit with their loved one, undisturbed until they are ready to leave. Often family members will have lots of questions, which I'll answer, or direct them to the coroner’s office. The doorbell rings again, and this time it’s the funeral directors coming to collect a deceased. Before they can do so, we check through all the necessary paperwork and confirm the coroner has released that body.

Lunch is usually at 1 o’clock. We try to take a break at the same time, allowing a chance to debrief or come down from the morning’s highs and lows. We’ll watch the news on TV and generally switch off.

Afternoon, and the post-mortem room needs to be re-stocked with equipment, the laundry put in the washer and all the paperwork prepared for the next day’s post-mortem list. I’ll normally be looking forward to finishing at 4pm, planning a trip to the gym or a drink with friends. However, today a phone call from the coroners officer informs us that there’s been a murder in our area, and the forensic pathologist wants to start the post-mortem at 5.30pm. We have one member of the team who’s on call and available out of normal working hours to deal with such events. On this occasion it's not me, I sigh with relief as I know these cases can last for 5-6hrs.

The phone continues to ring: more enquiries from families, funeral directors and a GP who needs to come over in the morning to identify one of his patients and view the body before completing the necessary paperwork so that the next of kin can register the death and make funeral plans. Four o’clock comes and, depending on my placement, home could be a B&B, hospital accommodation or, home if I’m lucky enough to be within travelling distance. I bid farewell to my colleague that has to stay behind and deal with the special post-mortem.

People seem to be scared to talk about death. Why? We all die at some point, so my advice is: life is for living so live it to the full. When your time comes, we’ll be here to look after you and your family.

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